Written by Roy C. Mercer (VFIS of Texas Director of Training, Education, and Safety) for Texas Firemen magazine.
2014 Texas Firemen magazine is available for SFFMA members. You can become a member by signing up at www.sffma.org.
The commonality between our emergency vehicles and all-terrain vehicles and utility vehicles (ATVs/UTVs) is that “they are still vehicles”. Providing a fast, fun to ride, low cost, easy to deploy, and navigable option, ATVs/UTVs are becoming more noticeable in emergency service organizations (ESO) across our state. Each ESO should place a high-level of seriousness towards the driver’s experience and training on this response vehicle. Additionally, the ESO should equally recognize that conversion of an ATV/UTV to an emergency vehicle encompasses a great deal of requirements. The ESO should consult the manufacture before embarking on the conversion process by adding a tank or an EMS skid unit themselves.
Utilization of ATVs/UTVs in our service has been around approximately 30 years now. As ATV/UTV equipment evolved, personal protection concerns among manufactures has increased. Even with warning safety labels and safety advertisements, personnel are still rejecting these important messages and are treating ATVs/UTVs as recreational vehicles. Furthermore, ESO’s are placing personnel in the driver’s seat for emergency response while never considering the education processes and/or maintenance needs before deployment. Emergency service organizations must perform an assessment to identify proper personnel protective equipment (PPE) purchase needs and/or offer the appropriate safety equipment for the response. The State of Texas requires helmets worn to meet the United States Department of Transportation standards. Additionally, gloves and goggles must be worn while transferring these vehicles across public terrain (Texas law, Section, 663.034).
Emergency service personnel are using these ATVs/UTVs like the bicycle theory: Once you ride one once, you’re good to go for life. This theory does not help reduce liability for the ESO. The ESO cannot ASSUME anything; personnel must be aware of dangers when driving, operating, and/or riding in or on these vehicles. Many causes of accidents on ATVs/UTVs fall into two categories: 1) Operator behavior and 2) Equipment failure. The U.S. Consumer Product Safety Commission, (Sarah Garland, February 2013), reported that from January, 1982 to December, 2011, 11,688 ATV/UTV deaths transpired across the U.S., with 571 happening in Texas, which is one of the highest death tolls of any state. Sadly, these fatalities occurred across all age groups. 35% of deaths occurred in those 16 years and younger, meaning that 65% of ATV/UTV fatalities featured victims over the age of 16. These numbers are shouting to the emergency organizations across the state, and we as ESO’s should take preventive proactive measures to avoid becoming part of such tragic statistics.
We encourage the implementation of preventable measures be done early, before the deployment of an ATV/UTV. As a risk management process, the utilization and research for the types of duties the vehicle is to endure are a high priority when developing specifications for the purchase of ATVs/UTVs. ESOs tend to gravitate towards the purchase of utility vehicles because it offers off and on road terrain diversity during operations at a low cost. In addition, these vehicles offer multiple passenger compartments allowing two – four people to ride in them. UTVs also feature beds capable of carrying skid units, a gas powered water pump, an attack line(s), and a tank of water; usually 50 – 65 gallons capacity (figure 1) for fire suppression activities. Additionally, removing the fire skid units allows diversity for converting the vehicle into an EMS vehicle, allowing for patient transport and medical supply to be place on-board (figure 2). Our recommendation is to consult with a professional manufacture of these vehicles, making sure that the load capacity is within the vehicle limits. Personnel and all the safety equipment should be included when determining this capability.
When consulting with the manufacture, the ESO’s should be very specific about the equipment carried on the AVTs/UTVs. Some example considerations are night and day operations, spot light bars placed on top, flashlights and mounts, PPE, and extra fuel tanks for long distance responses. If the ESO utilizes these vehicles as an emergency transport vehicle, all safety equipment should be on-board for the patient and family members. At a minimum, two personnel should respond within the vehicle at all times. Communication equipment should also be available as the vehicle travels to remote locations where signals may or may not be present, depending on location. First aid and/or survival kits need to be on-board as well as suntan lotion, flame blankets, extra drinking water, fire extinguisher, responder medication and snacks, considering the activity and terrain they will be traversing. Determining the appropriate type of PPE base on terrain operations is very important for the safety of personnel. For example, if your organization responds in a heavy wooded or weeded area, you may consider heavier leg and arm protection be worn. Additionally, a DOT certified helmet with built in face shield or eye protection, as well as sunglasses in bright areas, and gloves should be considered.
What about the terrain? Geo mapping is very important, giving the preplanning of the terrain a higher priority. The ESO will be traversing in areas that are not common. The development of preplans of recreational locations are crucial; where people hike, ride mountain bikes, horses, dirt bikes and other entertaining activities. When traveling off-road, most recommend traveling on dirt and/or areas traveled by other vehicles, including rutted and/or worn terrain. If this cannot be accomplished, a partner should walk in front of the vehicle and determine whether the vehicle can proceed forward in the unknown area safely. Remember, we usually respond down roadways within our district. When we go off-road in an unknown terrain, we could accidently travel in high water areas or fall from a shift of dirt or rock formation causing more injuries and even death.
Annual training is necessary, and identifying the risks associated with ATVs/UTVs is no different from other emergency vehicles within our fleet. Traversing over different types of terrains, the correct operations and maintenance procedures, personnel performance measures, and the proper use of PPE are very important subjects within the educational process. At a minimum, each person should attend 4-hours of classroom with another 4-hour of driving an obstacle course (off-road preferred). The classroom portion should cover the latest accident trends, safety equipment, terrain identification and/or mapping, maintenance processes, operation, driver qualifications, and lastly, trailer operations, which are equally important. Skill practice should consist of a preventive maintenance checklist, a cone driving course, flat field and/or level ground area, on-road surface and then an off-road guided experience (figure 3), and a post maintenance check and cleaning be performed.
Lastly, all ATVs/UTVs are important members of our vehicle’s fleet. Personnel should be aware of the risks associated with the utilization of these vehicles and response areas they will be traversing. All safety equipment worn and standard operating procedures developed and enforced should be reviewed by all personnel. These vehicles are not for recreation. They are for performing an important task, and the ESO’s implementation of best practices before the deployment of these vehicles is a proactive approach.
Remember, the safe response begins before the response.
We have received several calls from our clients on how to handle the current Ebola situation and what Ebola resources are available. Ebola is a disease caused by the Ebola virus that can lead to severe and often fatal disease in humans and some animals that become infected. Ebola virus is spread through direct contact with blood and body fluids of a person who is infected with Ebola and has symptoms, or who has died from Ebola.
According to Texas Department of State Health Services (DSHS), the U.S. Department of Health and Human Services (DHHS) Centers for Disease Control and Prevention (CDC) and Office of the Assistant Secretary for Preparedness and Response (ASPR), in addition to other federal, state, and local partners, aim to increase understanding of Ebola and encourage U.S.-based EMS agencies and systems to prepare for managing patients with Ebola and other infectious diseases. Every EMS agency and system, including those that provide non-emergency and/or inter-facility transport, should ensure that their personnel can detect a person under investigation (PUI) for Ebola, protect themselves so they can safely care for the patient, and respond in a coordinated fashion. Many of the signs and symptoms of Ebola are non-specific and similar to those of other common infectious diseases such as malaria, which is commonly seen in West Africa. Transmission of Ebola can be prevented by using appropriate infection control measures. EMS agencies, in conjunction with their medical directors, should review infection control policies and procedures and incorporate plans for administrative, environmental, and communication measures.
For complete information on what you and your organization need to do, visit the DSHS Ebola Resources Website or the CDC Ebola Resources website.
For additional questions or concerns, please contact DSHS or CDC.
By Bill Jenaway, Vice President, VFIS Education, Training and Consulting and President CFSI; Sean Carroll, Legislative Director CFSI; and Bill Webb, Executive Director CFSI
The recently enacted Patient Protection and Affordable Care Act (as amended by the Health Care and Education Reconciliation Act of 2010), has implemented a number of key changes that alters access to health care for individuals. The Act also has a number of impacts imposed to help pay for these changes in health care coverage. One of these is known as the “Cadillac Tax.” This provision imposes an annual 40 percent excise tax on plans with premiums exceeding $10,200 for individuals or $27,500 for a family (not including vision and dental benefits) starting in 2018.
The thresholds may be increased depending on actual medical inflation between 2010 and 2018 using a measure that looks to the Federal Employees Health Benefits (FEHB) program. The thresholds may also be increased for individuals in high-risk professions and pursuant to an age and gender adjustment. It is anticipated that the IRS will provide additional guidance regarding the thresholds and the adjustments to the threshold in its regulations.
The term Cadillac is used to describe the plan similar to that of the Cadillac automobile. The automobile has been known for its luxury, implying the Cadillac Health Care Plan is a luxury plan. Therefore, a Cadillac plan is any unusually expensive health insurance plan. The term gained popularity in the early 1990s when debates were occurring over health care plans during the Clinton Administration. This was followed by debate over possible excise taxes on Cadillac plans during the Obama Administration Health Care reform proposals. It should also be noted that bills proposed by Clinton and Obama did not use the term Cadillac.
The tax will apply to both fully insured and self-funded plans. For fully insured coverage that exceeds the applicable threshold, the issuer is responsible for paying the 40 percent excise tax. If it is self-funded coverage, the plan administrator (typically the employer) is responsible for paying the excise tax. The threshold is adjusted for individuals in high-risk professions, but only if a majority of employees covered by the plan are engaged in a high-risk occupation. This means a health care plan that covers only members of a fire department would be eligible for the increased threshold, but a plan that covers all municipal employees may not be eligible for increased threshold. Additional information about the thresholds and permissible adjustments will be addressed by the IRS in its regulations.
These high-value health plans are typical of the type of plans provided to high risk organizations such as fire and police agencies. So the first question is – Do you qualify? The second question is - Are you ready?
Taking care of emergency responder personnel is a responsibility of management and being safety/health conscious is a responsibility of both personnel and management. Thus, everyone in the organization plays a role in health care and in upcoming discussions of the Cadillac Tax and its impact. This issue will most likely be a discussion point during benefit discussions, contract negotiations, budgeting and strategic planning.
Even though the Cadillac Tax will not be effective until 2018, emergency service organizations may want to begin working with agents, brokers, consultants and insurers now to determine ways to manage the implications of the tax on benefit programs. This is particularly true if the organization has personnel engaged in future business planning activities, including collectively bargained plans where negotiations must take place before changes can be made to a plan. It is important for all those involved to have an understanding of the issues, the impacts on the responders and the organization, the options available and the decisions to make.
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